Imaging in ovarian Cancer

Abstract

• Ovarian cancer affects mainly post-menopausal women but is not uncommon in pre-menopausal women. • The presentation of ovarian cancer is usually delayed, and therefore early detection of disease is important. • Imaging has an important role in the detection and characterisation of adnexal masses with the primary imaging modality being transvaginal ultrasound. • Cross-sectional imaging is useful to assess the extent of disease prior to surgery, for monitoring treatment response and for detecting recurrence. Abstract. Ovarian cancer is the fifth most common cancer affecting women in the UK and is associated with a worse prognosis than other forms of gynaecological malignancy. There are increasing numbers of women presenting with ovarian cancer over the age of 65 years. The diagnosis of ovarian cancer is often delayed, owing to the lack of symptoms and the non-specific nature of the disease, particularly in the early stages. The prognosis of advanced ovarian cancer is poor in the later stages, making early detection of malignancy important. On current classification systems, the staging of ovarian cancer remains surgical but the role of imaging is contributory throughout the management of ovarian cancer which defines disease burden. The primary imaging modality for detection of ovarian disease is transvaginal ultrasound, and CT imaging is predominantly used in the staging of ovarian cancer with MRI being reserved as a problem-solving technique, especially in younger women where benign disease is more likely. Newer modalities such as positron emission tomography CT are increasingly being recognised in ovarian cancer where recurrent disease can be diagnosed more quickly with subsequent treatment. The role of imaging is discussed with reference to the different imaging modalities available in the assessment of ovarian malignancy. Ovarian cancer is the second most common gynaeco-logical cancer and is associated with higher mortality rates compared with other forms of gynaecological ma-lignancy. The incidence of ovarian cancer is approxi-mately 7000 cases per year in the UK [1]. The majority of